文摘
背景目前还不清楚为什么有些症状哮喘或慢性阻塞性肺病患者仍未确诊的。这里,我们比较病人和医生之间的特征症状阻塞性肺疾病患者(旧)诊断和患者被诊断出的老了。
方法使用随机数字拨号和以人群为基础的病例发现,我们招募了451名参与者与症状确诊205症状控制老参与者被诊断出的老了。数据症状、生活质量和医疗利用率进行分析。我们调查两组的参与者的家庭医生阐明医生实践的差异可能导致未确诊的老了。
结果参与者和未确诊的老较低意味着pre-bronchodilator用力呼气量在1 s比例预测与诊断(75.2%的人与80.8%;或0.975,95%可信区间0.963 - -0.987)。他们报道的社会心理影响更大,因为症状,更糟糕的是比那些被诊断为旧能源和疲劳。未确诊的老参与者中更为普遍的家庭医生执业15年>,在那些医生报告说,他们可能会开出不做肺量测定法呼吸系统药物。未确诊的老更普遍参与者从未经历了肺量测定法(或10.83,95%可信区间6.18 - -18.98)或从未被称为专家(或5.92,95%可信区间3.58 - -9.77)。未确诊的老中不太常见的参与者需要急诊护理(或0.44,95%可信区间0.20 - -0.97)。
结论患者症状确诊老糟pre-bronchodilator肺功能和现在有更大的社会心理影响生活质量与诊断同行相比。他们不太可能得到适当的调查和专家推荐的呼吸道症状。
文摘
有症状的哮喘或慢性阻塞性肺病患者肺功能差和更大的社会心理影响生活质量与诊断。他们不太可能得到适当的调查和专家推荐。https://bit.ly/3STkaek
脚注
作者的贡献:概念和设计:道。亚伦和G.A.惠特莫尔。分析和解释:m . Cherian K.M.A.无功功率,G.A.惠特莫尔道。亚伦。起草重要知识的手稿内容:m . Cherian K.M.A.无功功率,G.A.惠特莫尔,亚伦,时任K.L. Vandemheen, J.M.菲茨杰拉德,c . Bergeron c . Lemiere帮。Boulet,象牙海岸,e . Penz”栏目,s . Gupta R.A. McIvor,梅耶尔,m .同事·埃尔南德斯医学Lougheed, m . Ainslie C.J. Licskai, t . Azher:以察和美国的负责人。
利益冲突:m . Cherian报告无利益冲突。K.M.A.无功功率报告无利益冲突。G.A.惠特莫尔报告无利益冲突。K.L. Vandemheen报告无利益冲突。c . Bergeron报告赠款、合同或从诺华谢礼,Biohaven,阿斯利康,赛诺菲,法雷奥和Grifols;和咨询委员会参与赛诺菲、阿斯利康、葛兰素史克武田和法雷奥。帮。Boulet报告拨款、合同、咨询费或从安进谢礼,阿斯利康、葛兰素史克、默克公司Sanofi-Regeneron, Covis和诺华;从现时的和泰勒和弗朗西斯版税或许可证;领导角色的全球倡议哮喘(吉娜),全球哮喘协会(INTERASMA)和加拿大胸社会; and holds the Laval University Chair on Knowledge Transfer, Prevention and Education in Respiratory and Cardiovascular Health. A. Cote reports grants, contracts, consulting fees or honoraria from GlaxoSmithKline, AstraZeneca, Valeo, Sanofi-Regeneron and Covis; and advisory board participation with AstraZeneca, Sanofi and Valeo. S.K. Field reports grants, contracts, consulting fees or honoraria from Bayer, Insmed, Merck, Valeo and GlaxoSmithKline. E. Penz reports grants, contracts, consulting fees or honoraria from the Saskatchewan Health Research Foundation, CIHR, Respiratory Research Centre, SCPOR, AstraZeneca, Saskatchewan Cancer Agency, GlaxoSmithKline, Sanofi, Genzyme, ICBEM and Boehringer Ingelheim; and leadership roles with the Canadian Thoracic Society COPD Assembly, CIHR Institute Advisory Board and Youth4Change. R.A. McIvor reports no conflict of interest. C. Lemière repots grants, contracts, consulting fees or honoraria from GlaxoSmithKline, AstraZeneca, Sanofi and Novartis; and royalties or licences from UptoDate. S. Gupta reports no conflict of interest. I. Mayers reports no conflict of interest. M. Bhutani reports grants, contracts, consulting fees, support for travel or honoraria from the CIHR, AstraZeneca, GlaxoSmithKline, Novartis, Grifols, Sanofi, Covis, Valeo, Lung Association of Saskatchewan, Canadian Thoracic Society and Lung Association of Alberta and Northwest Territories; and leadership roles with the Canadian Thoracic Society and Alberta Health Services. P. Hernandez reports grants, contracts, support for travel or honoraria from the CIHR, Cyclomedia, Boehringer Ingelheim, Vertex, Grifols, AstraZeneca, Boehringer Ingelheim, Janssen and Canadian Thoracic Society; advisory board participation with Acceleron, AstraZeneca, Boehringer Ingelheim, Covis, GlaxoSmithKline, Grifols, Janssen, Novartis, Sanofi, Takeda and Valeo; and leadership roles with the Canadian Thoracic Society. M.D. Lougheed reports grants, contracts or honoraria from the CIHR, AstraZeneca, GlaxoSmithKline, Canadian Thoracic Society and MDBriefcase; advisory board participation with AstraZeneca; leadership roles with the Canadian Thoracic Society, Health Quality Ontario and the Lung Association. C.J. Licskai reports no conflict of interest. T. Azher reports no conflict of interest. M. Ainslie reports no conflict of interest. N. Ezer reports grants, contracts or honoraria from the CIHR, Rossy Cancer Network, Covis Pharma, GlaxoSmithKline, AstraZeneca, Fédération des Omnipracticiens du Québec and Médecin du Québec Magazine; advisory board participation with GlaxoSmithKline; leadership role with the Quebec Ministry of Health Lung Cancer Screening Implementation Committee; and receipt of study drug from Covis. S. Mulpuru reports no conflict of interest. S.D. Aaron reports honoraria from AstraZeneca, Sanofi and GlaxoSmithKline; and advisory board participation with AstraZeneca, GlaxoSmithKline and Sanofi.
支持声明:加拿大卫生研究所的研究,154322年FDN格兰特。资金信息,本文已沉积的Crossref资助者注册表。
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